Objective To investigate the clinical effect of Kangfuxin liquid topical treatment for open wound of perianal abscess.MethodsEighty patients with open wound were treated with perianal abscess from June 2015 to June 2016.The patients were divided into two groups according to their treatment group.Patients were treated with conventional regimen, while 40 patients in the observation group were treated with routine regimen+rehabilitation solution;the experimental data were compared between the two groups.The two groups were observed and compared the wound healing time (d), granulation growth cycle (d) and healing rate (%);the two groups were observed and compared the incision pain, edema, anal bulge and other symptoms disappeared time;compared two groups of clinical curative effect and complication rate.ResultsThe clinical treatment effect of the observation group was better than that of the control group, the difference was statistically significant (P<0.05).ConclusionThe clinical effect of the treatment of open wound in patients with perianal abscess with conventional therapy+rehabilitation therapy is significant, and the wound healing time is short, which is widely used in the treatment of open wound of perianal abscess.

Objective To evaluate the safely and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and its related procedures in patients older than 85 years.Methods Data of patients older than 85 who underwent ERCP between 2004 and 2009 (group A, n =52) were reviewed and compared with those of patients aging 70-84 years (group B, n = 329).Results The rate of patients with underlying disorders of other systems in group A was significantly greater than that of group B (100.0% vs.77.5% , P < 0.05) , as well as the rate of multiple procedures to achieve stone clearance (42.3% vs.28.8% , P <0.05).There were no significant differences between 2 groups regarding the rates of complication (7.7% vs.4.9% ) and post-procedure mortality (1.9% vs.0.6% ).Conclusion Therapeutic ERCP and related procedures are safe and effective in patients aging over 85, and advanced age should not be regarded as the contraindication of the procedure.

Objective To investigate the diagnostic value of intraductal ultrasonography for the quality of biliary stricture.Methods Data of the patients who had received operation because of biliary stricture after IDUS examination from 2006 to 2010 were collected.IDUS results were compared with those of operation.Results There were 43 cases of malignant strictures and 6 benign strictures in total.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of intraductal uhrasonography for the quality of biliary stricture were 97.7％ ( 42/43 ),83.3％ ( 5/6 ),97.7％ ( 42/43 ),83.3％ (5/6) and 95.9％ (47/49),respectively,which were significantly higher than conventional imaging like ultrasound B,CT and MRCP.Twenty one cases in 32 were diagnosed as malignant biliary stricture with cytological brushing,with the diagnostic accuracy of 65.6％.All cases had been diagnosed by IDUS.Conclusion Intraductal ultrasonography is of high diagnostic value for biliary stricture.However,cytological brushing based on IDUS is of limited diagnostic value for malignant biliary stricture.

Objective To investigate the clinical feature , pathologic characteristics and prognosis of urothelial carcinoma of bladder with squamous differentiation . Methods From Jan.2010 to Jun.2013, the pathological and clinical data of 96 cases of urothelial carcinoma of bladder with or without squamous dif-ferentiation were compared .Of the group with squamous differentiation , there were 39 males and 9 females with a median age of 70 (29 to 87) years.44 cases presented with painless gross hematuria .4 cases presen-ted with finding of bladder tumors in annual physical examination .TURBT, partial cystectomy and radical cystectomy were performed in 25, 8 and 13 cases, respectively.In addition, one case was only underwent bi-lateral ureteral skin gastrostomy .The last one only performed cystoscopy .In accordance with sex , age, path-ological stage and classification and surgical approach , 48 controls were selected .For the other group , there were 40 males and 8 females with a median age of 68 (39 to 86) years.45 cases presented with painless gross hematuria.3 cases presented with finding bladder tumors by annual physical examination .TURBT, par-tial cystectomy and radical cystectomy were performed in 28, 7 and 13 cases, respectively.All patients with retaining bladder had postoperative intravesical instillation for one year .Some patients with or without bladder performed 3-6 cycles chemotherapy with the GC protocol . Results In squamous differentiation group , there were 1 (2.1%) pTa, 25 (52.1%) pT1, 17 (35.4%) pT2, 4 (8.3%) pT3 and 1 (2.1%) pT4 tumors. Whereas, 1 (2.1%) pTa, 28 (58.3%) pT1, 16 (33.3%) pT2, 2 (4.2%) pT3 and 1 (2.1%)pT4 tumors were selected in the control group .There were 2 (4.2%) cases with low grade and 46 (95.8%) cases with high grade carcinomain in both groups .Patients were followed up with a mean duration of 16 and 12 months in squamous differentiation and control group , respectively .In squamous differentiation group , eight recur-rences were recorded with a mean follow-up of 12 months.Of the 3 died patients, only one died from bladder cancer.In control group, seven recurrences were recorded with a mean follow-up of 22 months, and no pa-tient died.For patients with TURBT, 3 year recurrence rate of patients with squamous differentiation was 49.5%, while the control was 34.8%.The difference was statistically significant (P<0.05). Conclusions Urothelial carcinoma of bladder with squamous differentiation is at a high level of malignant and recurrence . The rate of myometrial invasion with squamous differentiation is higher than pure urothelial bladder cancer . Patients with squamous differentiation should be closely followed up .

ObjectiveTo investigate the diagnostic value of single balloon enteroscopy (SBE) for obscure gastrointestinal bleeding.MethodsA total of 78 SBE procedures was conducted on 72 patients with obscure gastrointestinal bleeding,with 40 via oral route and 38 via anal route.The procedure time,insertion depth and rate of positive finding were recorded.ResultsFor 40 SBE procedures performed via oral route,the mean procedure time was 60 minutes ( 15-110 minutes),and the mean insertion depth was 195 cm at the distal end of Trentz ligament (30-240 cm).For 38 SBE procedures performed via anus,the mean procedure time was 75 minuets (30-120 minutes),and the mean insertion depth was 160 cm at the proximal end of ileocecal valve (50-200 cm ).The whole diagnostic yield of obscure gastrointestinal bleeding was 62.5％.ConclusionSBE is a safe and useful tool for the diagnosis of obscure gastrointestinal bleeding.

20 years)was 8.60%(48/558) , which was more than that in the second decade of life ( 5.22% ). The incidence of painful group was 9.79%(14/143),which was more than that in foot trauma group 6.78%(40/630).The positive C sign was presented in 61.1%(33/54),posterior-type coalition in 38.9%(21/54),short talar neck sign in 61.1%(33/54)and talar beak sign in 22.2%(12/54). Conclusion The talocalcaneal coalition is a common development abnormality in our country. We must pay attention to the diagnosis of talocalcaneal coalition for painful foot adulthood.

Objective To study the incidence and radiologic findings of calcaneonavicular coalition.Methods CR films of foot andankle in 1361 cases were presented,which were evaluated for acute trauma or chronic pain.There were 588 cases of foot CR and 773 cases of ankle CR,age ranged from 10 years to 91 years(984 cases of 20~40 years).The prevalence of calcaneonavicular coalition was determined and the different significance of both male and female,acute trauma and chronic pain group were analysed.Results In 1361 cases,72 cases of calcaneonavicular coalition(5.3%) were demonstrated,8.7%(47/588)on foot CR films and 3.2%(25/773) on ankle CR films.Calcaneonavicular coalition was more dipicted on foot CR films than on ankle CR films(P0.05).Conclusion The foot CR films is more superexcellent than the ankle CR films on demonstrating calcaneonavicular coalition.

Objective To study the clinicoradiologic significance of C sign.Methods 773 cases of standard ankle CR radiographs were presented for diagnosis of acute trauma and ankle pain. There were 565 males and 208 females, ages ranged from 10 to 81. There were 630 cases of acute trauma and 143 cases of painful ankle. C sign incidence, C sign figuration, distance of the medial facet of talocalcaneal joint, and the figuration of sustentaculum tali were studied. The relationship between C sign and talocalcaneal coalition was analysed.Results The incidence of C sign was 54.6%(422/773). The female incidence was 61.1%(127/208) ,which was more than that of male(52.2%,295/565)(P

Objective To detect the expression of Beclin1 and Bcl2 in invasive pituitary adenomas and to explore the relationship of Beclin1 and Bci2 in invasive pituitary adenomas and the relativity between the 2 genes.Methods 61 specimens were classified into invasive group (32 cases) and non-invasive group (29 cases) according to the comprehensive evaluation of invasive pituitary adenomas.lmmunofluorescence analysis and RT-PCR were adopted respectively to detect the protein and mRNA expressions of Beclinl and Bcl2.The difference and relativity of Beclin1 and Bcl2 expression in invasive group and non-invasive group were analyzed.Results 32 specimens of pituitary adenoma were invasive and 29 were non-invasive.Beclin1 protein and mRNA expressions were lower in the invasive group than in the non-invasive group (P ＜0.01 ).Bcl2 protein and mRNA expressions were higher in the invasive group than in the non-invasive group (P ＜0.01 ).Pearson related analysis showed that Beclin1 mRNA expression was negtively correlated with Bcl2 mRNA expression in the invasive group ( r =-0.42,P =0.028 ).Conclusions Beclinl expression is decreased in invasive pituitary adenomas.The invasiveness of pituitary adenoma is closely related to the high expression of Bcl2 protein and mRNA,and the low expression of Beclin1 protein and mRNA.The inhibition of the autophagy may lead to the enhancement of the invasiveness of pituitary adenomas and that inhibition may come from the interaction of Beclin1 and Bcl2.

Objective:To analyze risk factors for prognosis of adult patients with traumatic brain injury (TBI), construct the prognostic model of TBI and evaluate its predictive value.Methods:A case-control study was used to analyze the clinical data of 522 patients with TBI admitted to Xijing Hospital of Air Force Medical University from March 2011 to September 2019, including 438 males and 84 females; aged 18-75 years [(44.9±15.0)years]. According to the Glasgow outcome score (GOS) at discharge, the patients were divided into good prognosis group (GOS 4-5 points, n=165) and poor prognosis group (GOS 1-3 points, n=357). The two groups were compared with regards to qualitative data such as sex, underlying diseases, causes of injury, multiple injuries, open injuries, intracranial foreign bodies, cerebral herniation, consciousness status on admission and at discharge, surgery, lung infection on admission, tracheostomy, ventilator-assisted ventilation, hospital-acquired pneumonia/pathogenic bacteria and intracranial infection, and quantitative data such as Glasgow coma score (GCS) on admission and at discharge, age, measurements on admission [systolic blood pressure, diastolic blood pressure, mean arterial pressure, temperature, heart rate, creatinine, urea nitrogen, blood sodium, blood potassium, blood glucose, prothrombin time (PT), activated partial thromboplastin time (APTT), platelets, international normalized ratio (INR), pupil size of both eyes] and length of hospital stay. Univariate analysis and Lasso regression analysis were used to screen the risk factors affecting the prognosis of TBI patients, and the selected influencing factors were included in multivariate Logistic regression analysis to identify independent risk factors and construct regression equations. R was used to draw a visual nomogram based on regression equation for predicting the prognosis of TBI patients. The prognostic predictive value of the nomogram was evaluated by using the receiver operating characteristic (ROC) curve, and the area under the curve (AUC), Youden index, sensitivity, specificity and consistency index (C index) were calculated. Results:Univariate analysis showed that there were significant differences between the two groups in underlying diseases, open injuries, cerebral herniation, consciousness status on admission and at discharge, lung infection on admission, tracheostomy, ventilator-assisted ventilation, hospital-acquired pneumonia/pathogenic bacteria, GCS on admission and at discharge, age, and measurements on admission (systolic blood pressure, mean arterial pressure, body temperature, heart rate, creatinine, urea nitrogen, blood potassium, blood glucose, PT, INR, pupil size of right eye) (all P<0.05 or 0.01). There were no significant differences between the two groups in gender, causes of injury, multiple injuries, intracranial foreign bodies, surgery, intracranial infection, measurements on admission (diastolic blood pressure, blood sodium, APTT, platelets, pupil size of left eye) and length of hospital stay (all P>0.05). After screening by Lasso regression model, the results of multivariate Logistic regression analysis showed that GCS on admission ( OR=0.67, 95% CI 0.62, 0.73, P<0.01), age ( OR=1.03, 95% CI 1.01, 1.04, P<0.01), blood glucose on admission ( OR=1.17, 95% CI 1.06, 1.30, P<0.01) and INR on admission ( OR=17.08, 95% CI 2.12, 137.89, P<0.01) could be used as the main risk factors to construct the prediction model, and the regression equation was constructed: Logit [ P/(1- P)]=-0.398× "GCS on admission"+0.024× "age"+0.158×"blood glucose on admission"+2.838×"INR on admission"-1.693. The AUC for the prognosis prediction in adult patients with TBI using R based on a visual nomogram model was 0.87 (95% CI 0.83, 0.89, P<0.01). The Youden index for the predicted probability was 0.60 (sensitivity of 85.2% and specificity of 75.2%), with the C index of 0.87. Conclusion:Age, GCS on admission, blood glucose on admission and INR on admission are the main risk factors affecting the prognosis of TBI in adults, and the nomogram drawn by these parameters can better predict their clinical outcome.